Viral Encephalitis in Humans
http://www.100md.com
《新英格兰医药杂志》
Viral encephalitis in Humans brings to the forefront the extensive experience of Dr. Booss, the national director of neurology for the Department of Veterans Affairs, and Dr. Esiri, professor of neuropathology at the Oxford Radcliffe National Health Service Trust in the United Kingdom. The preface notes that this textbook is organized to allow the practicing clinician to better approach the care of patients with viral encephalitis. The book moves logically from the evaluation of the patient to the discussion of specific syndromes in both immunocompetent patients and immunocompromised patients. A principle informing the book is the elaboration of pathogenesis. Acute sporadic encephalitis and the parainfectious, epidemic, subacute, and chronic forms of viral encephalitis are considered in detail.
The book has two main strengths. The first is the correlation of histopathological evidence of disease with gross brain pathology, magnetic resonance imaging scans, and the pathogenesis of each of the chief clinical syndromes. It is difficult to find a comparable textbook that contains such detailed histopathological evidence and a correlation with images of central nervous system disease. Indeed, the quality of the histopathological reproductions, scans, and gross pathological images of the brain is a tribute to ASM Press and to the authors' collection of wonderful slides. The second strength of the book is its orientation toward patient care. Understanding the value of clinical presentation, neurodiagnostic evaluation, and the contribution of the assessment of cerebrospinal fluid to diagnostic procedures is important to the practicing physician.
Viral infections of the central nervous system range from meningitis to encephalitis, with two exceptions, the herpes B virus and rabies virus; encephalitis is the only consequence of infection of the central nervous system by these viruses. This book focuses exclusively on viral encephalitis. In my opinion, the authors underrepresented the contribution of the polymerase chain reaction (PCR) to the diagnosis of viral diseases of the brain. The clinical virologist, the specialist in infectious diseases, the neurologist, and the general practitioner must become familiar with the use of the PCR assay in the detection of viral nucleic acids in cerebrospinal fluid; they must also become familiar with the important limitations of this test, if the treatment of viral encephalitis is to improve.
The authors provide us with a table of therapies for viral encephalitis without, however, distinguishing between licensed and experimental approaches. To suggest that interferon alfa, ribavirin, and pleconaril are efficacious in the treatment of viral disease of the central nervous system misleads the readers of this otherwise excellent textbook.
In spite of its limitations, this is an outstanding textbook, particularly for aficionados of viral diseases of the central nervous system. Its orientation toward the patient and diagnostic approaches will provide benefits for the specialist who cares for these patients.
Richard J. Whitley, M.D.
University of Alabama at Birmingham
Birmingham, AL 35233
rwhitley@peds.uab.edu(By John Booss and Margare)
The book has two main strengths. The first is the correlation of histopathological evidence of disease with gross brain pathology, magnetic resonance imaging scans, and the pathogenesis of each of the chief clinical syndromes. It is difficult to find a comparable textbook that contains such detailed histopathological evidence and a correlation with images of central nervous system disease. Indeed, the quality of the histopathological reproductions, scans, and gross pathological images of the brain is a tribute to ASM Press and to the authors' collection of wonderful slides. The second strength of the book is its orientation toward patient care. Understanding the value of clinical presentation, neurodiagnostic evaluation, and the contribution of the assessment of cerebrospinal fluid to diagnostic procedures is important to the practicing physician.
Viral infections of the central nervous system range from meningitis to encephalitis, with two exceptions, the herpes B virus and rabies virus; encephalitis is the only consequence of infection of the central nervous system by these viruses. This book focuses exclusively on viral encephalitis. In my opinion, the authors underrepresented the contribution of the polymerase chain reaction (PCR) to the diagnosis of viral diseases of the brain. The clinical virologist, the specialist in infectious diseases, the neurologist, and the general practitioner must become familiar with the use of the PCR assay in the detection of viral nucleic acids in cerebrospinal fluid; they must also become familiar with the important limitations of this test, if the treatment of viral encephalitis is to improve.
The authors provide us with a table of therapies for viral encephalitis without, however, distinguishing between licensed and experimental approaches. To suggest that interferon alfa, ribavirin, and pleconaril are efficacious in the treatment of viral disease of the central nervous system misleads the readers of this otherwise excellent textbook.
In spite of its limitations, this is an outstanding textbook, particularly for aficionados of viral diseases of the central nervous system. Its orientation toward the patient and diagnostic approaches will provide benefits for the specialist who cares for these patients.
Richard J. Whitley, M.D.
University of Alabama at Birmingham
Birmingham, AL 35233
rwhitley@peds.uab.edu(By John Booss and Margare)